HomeMy WebLinkAboutZ-29891FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 29891
Date: 12/05/03
THIS CERTIFIES that the
building
DWELLING
Location of Property
1165 EAST
GILLETTE DR
EAST MARION
(HOUSE
NO.)
(STREET)
(HAMLET)
County Tax Map No. 473889
Section 038
Block 0004
Lot 019
Subdivision
Filed Map No. Lot No_
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 29891 dated DECEMBER 5, 2003
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING WITH ATTACHED GARAGE *
The certificate is issued to VERNON E & & SALLY T. JACOBS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL
NO.
PLUMBERS CERTIFICATION DATED
*PLEASE SEE ATTACHED INSPECTION REPORT.
Rev. 1/81
N/A
N/A
1140, W
Au orized Signature
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1165 EAST GILLETTE DR EAST MARION
SUBDMSION: MAP NO.: LOT (S)
HAM OF OWNER (S): VERNON E & & SALLY T. JACOBS
OCCUPANCY: SINGLE FAMILY DWELLING VERNON E & & SALLY T. JACOBS
ADMITTED BY: VERNON E. JACOBS ACCOMPANIED BY: SAME
KEY AVAILABLE: SUFF. CO. TAR MAP NO.: 38.-4-19
SOURCE OF REQUEST: WM. PRICE, 10/20/03 DATE: 12/05/03
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME ■ STORIES: 1.0 * EXITS: 2
FOUNDATION: CEMENT BLOCK CELLAR: FULL CRAWL SPACE:
TOTAL ROOMS. ISP FLR.: 5 2ND FLR.: 0 3RD FLR.: 0
BATHROOM(S): 1.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S):
FORCE TYPE: DECK TYPE: PATIO TYPE:
BREEZEWAY: FIREPLACE: ONE GARAGE: 2 CAR
DpBSTIC HOTKKTER: XX TYPE BEATER: OIL AIRCONDITIONIMG:
TYPE BEAT: OIL HARM AIR: HOTWATSR: XX
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF C=ST.:
SWIMMING POOL:
OTHER:
STORAGE, TYPE CONST.:
GUSSP, TYPE CONST,:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
naaarc: BP$8182Z&9046Z-SWIMMING POOL&UTILITY ROOM-COZ7687-CORRECTED COZ-29890
INSPECTED BY: / �/J7(`(/t/� DATE 09 INSPRMON: 00/00/00
MICHAEL J. VERITY TIME START: 10:00 AM END: 10:30 AM
hUtlll 1101 V
TOWN of soUTHoLD l
BUILDING DEPARTMENT
TOWN HALL
765-1002 OCT 2 0 2003
APPLICATION fOR.CERTLFICATE OF OcCUPAN Y
I 1
A. This application must be filled in by typewriter OR ink sud bml`tted-to ttte bulid P
inspector with the following) for new building or stew Uset
l+ Final survey of property With decUrdto location of all buildings; property titles,
straetat and Unusual tiatUrdl be topographic fedturedt '
2a Final Approval from health Uept+•ofWater supply and sawerage-disposdl(S-9 form),
J+ Approval of electrical installdtiod from goard of Fire UnderWriterdt
4+ Sworn stateluettt from plumber certifying that the solder used in system codtalas
). less than 2/10 of 12 lend.
S+ Commercial buildings indus.ttidi buildings multiple restdettced and similar WWII
and installationsi a certificate of Coda Compliatled from'drebitbct or engineer
responsible for the building,
6+ Submit planning Board Approval of completed site pled requirements.
II
U+ For existing buildings (prior to April 9; 1957) non -conforming Uses; or buiidfngd w
Upte-existing" land Usest
L4 Accurate survey of property sltowing ail property )mess streets; building and .,
Unusual natural or topographic f'eaturdsa
21 A properly completed. application and d consent to inspect signed by the appltcan
If a Certificate of Occupancy i9 dettieds the Building inspector shall state the
reasons therefor id Writing to the applicant+
es Fees
14Certificate of Occupddcy - NOW dwelling $25+Ods Additions to dwelllnq 25,00i
Altetations to dwelling $25:00; SWitmning pool $'2is00s Accessory building + O;
Additfottd to accessory building $25100+ Businesses 50:00,
2. Certificate of Occupancy.on Pre-existing BulWng .100:00
3, Copy of Certificate of Occupancy - $5.00 aver 5 years - O:OO
41 Updated Cettificatd of occupancy — $50,00
51 'temporary Certificate of OccUpditcy - Residential /15:00; Cc" arcinl. 315:00
Dote
New Consttuctiona+++iata+++ Old or Pro-exidting
Locption of Propertyaaat1116i5aa,a,+aaa++alFi�� til�a�}�a�ata9tt%xl��'Ra:+a,aFid$taMdxioai+::aj:
House Nei Street Hamlet
Onwet or Owners of Property+aaai7iPirt 4 ++FiaaifF+c111 tfF�l1//S�1rltYiaTa++dcaQ41D5a,.:a+a+:aa++aa
County Tax trap No
Sections+iisi+00++I++B1ockla, 0400+ 019,000+ at
$ubdlViaian:.,fla:+++l+:/+li++ll alaa+l+,+.at4#IFIIad ttapl,:,+aI,,44,Lot..,:++:11++1+:u
1
Pa rMit Ito it a+Ja a a a++'c s+i':bat d Dt ettrmit,+ aatt It& a it a,+,App i team s+,t+ It a s 1111 it a a a 1.: j
hedith Dept, Approval+t+,+tea+a,+t+++t aaltata++Underwriters Approval,:aas++.++++.+t+•i++
Pldnding board ApproVdi,as++tts+aaa++a+a;a++:a+
Request fort +Temporary Cettificate+iataa+al++ Final Cetticate++aa}i,t/+++
Fee SUbmittedt;
APPLLCA1Jt
Ca ao7f &q I William H. Price,' JR.
LAWRENCE M. TUTHILL
PROFESSIONAL ENGINEER
P.O. BOX 162
GREENPORT, N.Y. 11944
(631) 477-1652
December 6, 2003
Southold Town Building Department
Main Road
Southold, NY
To Whom It May Concern:
Re: Residence of Vernon Jacobs
1165 East Gillette Drive
East Marion, NY
SCTM # 1000 38 4 19
I have inspected the cellar of the above mentioned
residence and foundthe cellar to be non habitable space.
Sincerely,
--- � ��
Lawrence M. Tuthill., P.E.
MANOR RD,
N 8T23'304E
LOT 74
STOCKADE PEN
a u�
LOT 76
n 11n1f 1VI0[ ��J ro aanw ;
� a0
r a�• Q Ol
F o! n
o
0,2'
o
0.2'
CONCRETE
0
ISX36
IN-OROUND
POoI. g
g
ro
a
R
M 4I'
• ar
SURVEYED: 16 OCTOBER 2003
SCALE 1'- 20'
AREA - 10.000 S.F.
LOT 7f 0.220 ACRES
IN
MAP OF MARION MANOR
EAST MARION,: TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
A2038 SURVEYED FOR: CARYN KLEIN SURVEYED BY
N FILED MARCH 18, 1053 STANLEY J. ISAKSEN, JR.
P.O. BOX 294
Mr 1000-038-oa-010 *U.
N.'f.:- } 36
;UARANI'EEO TO:
C1RYN KLEIN
STERLING NATIONµ MORTGAGE CO., INC. —
COMMONWEAIpj UND MOTE INS, CO. OR
,9273 03R1270
0
f.6
1
ORNEWAv
m GARAGE.0•+
r-30.2'
1 STORYf1
cowRESIDENCE
7.0'
STOCKADE PEN
a u�
LOT 76
n 11n1f 1VI0[ ��J ro aanw ;
� a0
r a�• Q Ol
F o! n
o
0,2'
o
0.2'
CONCRETE
0
ISX36
IN-OROUND
POoI. g
g
ro
a
R
M 4I'
• ar
SURVEYED: 16 OCTOBER 2003
SCALE 1'- 20'
AREA - 10.000 S.F.
LOT 7f 0.220 ACRES
IN
MAP OF MARION MANOR
EAST MARION,: TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
A2038 SURVEYED FOR: CARYN KLEIN SURVEYED BY
N FILED MARCH 18, 1053 STANLEY J. ISAKSEN, JR.
P.O. BOX 294
Mr 1000-038-oa-010 *U.
N.'f.:- } 36
;UARANI'EEO TO:
C1RYN KLEIN
STERLING NATIONµ MORTGAGE CO., INC. —
COMMONWEAIpj UND MOTE INS, CO. OR
,9273 03R1270
0
CONSLNT
'1'O
INSPRC111I6N
William H. Price, Jr., as agent for
Varnnn F_ 7arnbs and Sally,T. Jacobs , the unde'rsig'ned,
Owncr(s) Nafne(s)
do(es) liel•eby state:
That the undersigned (ts) (aru) the owner(s) of the premises in the 'Town
of Southold located at 1165 East Gillette Drive, East Marion, NY
which is shown and designated on the Suffolk
County tax map as District 1000, Section 038.Og Block 04.00 Lot 019.000
That the undersigned (leas) (have) filed, or caused to be filed, an applica-
tion in the Southold
'Town Building
Inspector's Office
for tyle following:
Pre -Certificate
of Occupancy,
Certificate of
Occupancy for
Addition (Building Permit #90462 issued 2/18/77)
That the undersigned do(es) hereby give consent to the Building Inspectors
of the 'Town of Southold to enter upon the above described property, including
any and all buildings located thereon, to conduct such inspections as they may
demi necessary with respect to the aforesaid application} includirrg inspections
to determine that said premises comply with all of the laws, ordinances, rules
and regulations of the Towll of Southold.
The undersigned, ill consenlfnrl to SU --)l inspections, do(es) so with the
knowledge and understanding that any btforntation obtained In the conduct of
such inspections may be used as evidence in subsequent prosecutions for. vio-
lations of the laws, ordinances, rules or regulations of the Town of Southold.
Dated; 10/17/03
Alifgnature)
William H. Price, Jr.
(print name)
8 is ll at ure
TOWN OF SOUTHOLD PROPERTY RECORD CARD
M -yo
OWNER
STREET
VILLAGE
DIST.
SUB. ✓' LOT"
FORMER OWNER
N
E
ACR.
,a d
S W TYPE OF BUILDING
TS. 21u SEAS. VL. FARM COMM. CB. MISC. Mkt. Value
LAND
IMP.
TOTAL
DATE
t
REMARKS�/
?lfl7,f d z 41110,
v
i o a
3
% %Q YdZ.. 2.� aa%arr rb.f. ��C. ,ZTlJ { dk iuc.
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW ABOVE
FARM
Acre
Value Per
Acre
Value
Fillable 1
Fillable 2
"illable 3
Voodland
swampland
FRONTAGE ON WATER
Srushland
FRONTAGE ON ROAD
louse Plot
DEPTH
i. r+
BULKHEAD
otal
DOCK
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMAiiSS:
/A/
DATE
1
� ,1 c
LOCATION: �7 s �� f
(number & street)
SUBDIVISION:
NAME OF OWNER(S):
OCCUPANCY: .Sii
(type)
"w -"r /
(municipality)
MAP NO.: LOT(S):
026�4 S-zle"111
(owner -tenant)
ADMITTED BY:/� r` ACCOMPANIED BY:
KEY AVAILABLE: SUFF. O. TAX MAP NO. 1000- 3
SOURCE OF REQUEST: �0DATE: /d///7%d.�
DWELLING:
TYPE OF CONSTRUCT ON: Gt�i'��� wee # STORIES: elY # EXITS: �—
FOUNDATION: , CELLAR: rZ27 CRAWL SPACE:
TOTAL ROOMS: 1ST FLR:_ 2ND FLR: 3RD FLR:
BATHROOM(S): ® tY P TOILET ROOM(S): 0IV-e. UTILITY ROOM:
PORCH TYPE: DECK, TYPE: PATIO, TYPE:
BREEZEWAY: FIREPLACE: Ne_ GARAGE:,, -7
DOMESTIC HOTWATER: _ TYPE HEATER: AIRCONDITIONING:�
TYPE HEAT: Irl WARM AIR: HOTWATER: )W�
OTHER:
ACCESSORY STRUCTURES:
GARAGE, TYPE OF C NST.:
SWIMMING POO157_L24,"
OTHER:
STORAGE, TYPE CONST.:
GUEST, TYPE CONST:
VIOLATIONS: CHAPTER 45 & N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
REMARKS:
INSPECTED BY: %'fie DATE ON INSPECTION:
TIME START: END: